An efficient workflow for alcohol misuse screening

Screening adult patients for alcohol misuse is a grade-B recommended service according to the American Academy of Family Physicians and the U.S. Preventive Services Task Force, and it was added as a HEDIS (Healthcare Effectiveness Data and Information Set) quality measure this year. It doesn’t have to be time-consuming, and the service is often billable, particularly when the results lead to a brief intervention. Here is an efficient workflow that keeps physician work to a minimum:

1. Front-desk personnel ask the patient to fill out a brief prescreening instrument. This can be a separate patient intake form or questions embedded into an existing form about health-related behaviors.

2. The medical assistant or nurse who rooms the patient scores the questionnaire, determines the need for a full, validated screening instrument (such as AUDIT, the World Health Organization’s Alcohol Use Disorders Identification Test), administers it when appropriate, and documents the results in the patient's record for the physician to review.

3. When indicated, the physician engages in a brief intervention to support the patient either cutting back or quitting alcohol use.

4. The team documents and codes according to Medicare and private payers’ instructions, which differ depending on the scope of services. Several codes exist for this purpose, including HCPCS codes G0396 and G0442 and CPT codes 99408 and 96160.

Adapted from “Using Alcohol Screening and Brief Intervention to Address Patients’ Risky Drinking.”